For years, a full-time Chief Medical Officer was rare and only a handful of positions existed, typically held by a respected physician who no longer wanted, or was unable, to maintain a clinical practice.  The number of physicians enrolled in a graduate management degree program with an eye on the executive suite was miniscule.

All of that has changed, even for many hospital CEOs who once swore they would never appoint a full-time physician executive.  From quality and safety of care to prickly competitive issues, there has been an explosion in the number of physician executives with titles such as Vice President of Medical Affairs, Vice President of Quality and Safety, Vice President of Clinical Affairs and, in an era where the term “chief” holds an important hierarchical significance, you have positions such as Chief Informatics Officer and, of course, Chief Medical Officer.

The success of a new physician executive is not automatic, even for an internal candidate.  Getting medical staff buy-in for the position, the role, and the all-important “definition of success” is critical.  If you are familiar with the concept of onboarding, you know that these steps are important pillars of this essential process; without the support of influential members of the medical staff and a clear definition of goals, objectives, and a picture of success, you run a very real risk of creating more problems than you will solve.  Chief Executives should take the following steps regardless of whether it is a new position or a replacement.

  1. From the initial informational conversations with physician leaders to formal “onboarding” planning, CEOs should formalize job criteria, scope of responsibility and deliverables.  Do not breeze through these steps.  Given the potentially dicey political and professional issues the physician executive may have to address, it is important that members of the medical staff, board members, and other members of the leadership team are asked for their input.
  2. As a CEO do not take anything for granted, especially with any internal candidates.  Remember, there are not that many experienced CMOs.  Most CEOs “take one to raise,” as my wonderful Grandmother Jackson liked to say. Talk in detail about organizational culture, how decisions get made and your likes and dislikes regarding reporting, communications, taking initiative, etc.
  3. Onboarding is NOT a pre-employment activity.  Develop a resource/coaching mechanism for the new physician executive.  Doing a new job when there is a lack of years of experience is a tough proposition, when the job is new or both.  Unless you enjoy watching people struggle, do not think these three suggestions are a waste.  The last time I looked, most physicians do not get the benefit of a leadership internship in medical school.

This may seem like the kind of stuff that everyone knows.  Yes, but you would be shocked at the number of train wrecks that occur in executive search precisely because these issues were not addressed.

© 2012 John Gregory Self